Advanced Applications of Cone Beam Computed Tomography in Orthodontics

This article describes the advanced cone beam computed tomography (CBCT) applications in orthodontic diagnosis and treatment planning. The limitations of conventional 2-dimensional planar film are discussed, and case examples are described that highlight the additional diagnostic information and many benefits derived from 3-dimensional imaging. CBCT software can manipulate the Digital Imaging and Communications in Medicine (ie, DICOM) data to visualize anatomic structures and accurately display relationships within the craniofacial complex. A combination of volumetric reconstruction and multiplanar views can provide the orthodontic clinician with skeletal hard tissue, soft tissue, dentition, and airway information. Nonstandard orthodontic cases, such as impacted teeth, supernumerary odontomas, or unexpected radiologic observations, such as pathologic lesions or incidental findings are best visualized with the 3-dimensinoal CBCT scan. Advanced CBCT software applications also can be used to quantify airway space (relevant for sleep apnea cases), perform superimpositions of objects at different time points to semiquantitatively visualize changes (eg, mandibular growth, temporomandibular joint, airway), and generate digital dental models to streamline the workflow in the orthodontic clinic.